APPENDIX XIV: Confined Space Rescue – Awareness (Sample)

Course Description:

This course is designed to provide adequate education and training for personnel who

have potential to be first responders to a confined space rescue incident. This course

provides information on identification of confined spaces, common hazards associated

with confined spaces, and operational limitations for the first responder.

Course Objectives

Terminal Objective:

To offer safe scene management and emergency operations during a confined space

incident. This is designed to prevent injury or death to the rescue worker while operating

within applicable laws and administrative policies.

Enabling Objectives:

Upon completion of this course, the firefighter shall demonstrate the ability to:

Related Performance Standards:

- NFPA 1001: 4-4.2 (1997 edition)

- WAC 296-305-05003

- WAC 296-62-145, Part M

Course Materials

Suggested Materials:

Essentials of Firefighting, IFSTA 4th

Edition, chapter 7

Applicable policies and procedures

Video – Confined Space Rescue, First Due Rescue Company; American Safety

Video Publishers

Student handout – Confined space entry permit

Confined space quiz and answer key

Course Overview

Preparation

Introduction/Motivation 15 Minutes

I. Presentation

Definitions/Training Levels

Types of Confined Space

Associated Hazards

175 Minutes

Video-Confined Space Rescue

Roles and Responsibilities

Legal requirements

Conclusion

II. Application

Discussion Questions 30 Minutes

III. Evaluation

Quiz (20 questions) 20 Minutes

I - Preparation 15 Minutes

1. Introduction/Motivation

Introduce self, class, and any special concerns or

conveniences.

Cover course objectives.

II - Presentation 90 Minutes

Explain:

1. Define confined space and training levels

This tends to be a High risk / Low frequency type

of incident, however, with the area growth and

vast amount of construction the potential for an

incident is much greater.

TECHNITIAN (40-60 hours training) - Special

skills and retrieval systems, patient evacuation,

communications and command, familiarity with

various types of confined spaces, monitoring-

assessment-ventilation techniques. THIS IS NOT

YOU!!!

OPERATION (several days training) - Safe entry

and rescue techniques, atmospheric monitoring,

assess hazards and risks. THIS IS NOT YOU!!!

AWARNESS (few hours training) – Recognize,

secure, and call for resources. THIS WILL BE

YOU!!!

2. Other key definitions

These are not the only definitions associated with

Confined space rescue, but are the critical ones

you should know and understand.

3. Types of confined space

Trench / excavation: (Be sure to cover Trench in

detail explaining to students that while considered

by standards to be different from confined space

techniques, Awareness level roles and

responsibilities remain the same.)

- All soils considered unstable for rescuers

concern; after all, rescuers are most likely there

because of a previous collapse

- Trench defined as excavation deeper than it is

wide

- > 4’ depth requires shoring, >20’ requires

engineered shoring

- Means of exit required w/in 25’ of work area

- Spoil pile must be >2’ from excavation

- Required shoring material is 6"x6" stock

(Rescue argues 4"x4"is acceptable).

Vaults:

Most common vaults in our area are underground

utility and mechanical Vaults.

Manholes:

Could be access to a vault but more common in

our area to be access to sewer, water, and storm

drain systems.

Storage tanks:

Above or below ground holding tanks for fuel,

water, septic, or other.

Building collapse:

Being in an earthquake prone area and having

older structures that have not been retrofitted, we

have a good potential for structural collapse.

Explain how voids can be created within a fallen

structure.

Silos:

Luckily we don’t have many, if any at all, within

4. Hazards associated with confined space

Atmospheric problems - This is the greatest

reason for concern in most confined space

situations and account for 60% of confined space

deaths. In confined spaces, many gasses linger and

present an IDLH condition both in the form of

inhalation dangers as well as flammable /

combustible (LEL) dangers. Many of these gasses,

which displace the oxygen, are colorless, odorless,

tasteless, and deadly. Discuss briefly some of the

effects of gasses that may be present in a confined

space such as CO, CO2, Methane, and Hydrogen

Sulfide.

Fall hazards - Most confined space

configurations are below ground or elevated and

are accessed by steep ladders. These ladders are

usually slippery and are made with small foot

surfaces (i.e. steps in a manhole)

Electrical or mechanical hazards - Vaults that

store these items will create an extra hazard inside

a confined space. If possible secure power to

reduce risk.

Engulfment danger - This is a special

consideration in confined space where the area

can be immediately Filled or flooded with gas,

liquid, or fire with little or no warning.

Collapse potential - In trench rescue or building

collapse scenarios where scene is already unstable

(thus the reason for rescue), expect further

deterioration of the area.

Equipment limitations - Bunker gear while being

good heat protection is poor protection from

chemical and/or corrosive agents. SCBA’s are

limited in confined space because of their

bulkiness. Need proper tools and equipment to

ensure safe operation, including fall protection,

which we may not have.

Improper training / manpower - Rescuers do not

plan to die when trying to help those in need.

These are good people with good intentions that

lack understanding of the situation. They are

unable to recognize all hazards and lack

knowledge on potential risks. Confined space

emergencies are VERY labor intensive; make sure

you have ample manpower.

II – Presentation, Video

Show video – Confined Space Rescue

25 Minutes

II – Presentation, continued 60 Minutes

5. Roles and responsibilities of the first

responder

IMS

For a successful operation, it is imperative that

command structure is developed early. Start IMS

to handle the worst and downgrade as necessary

for it is easier to reduce command structure than

to expand it after operations begin.

Evaluate

Figure out if there is a confined space emergency

to begin with, determine the number of patients (if

any), and determine if it is rescue vs. recovery.

Hazards

Identify if any hazards are present, to what extent,

and special considerations because of hazards. Is

there any type of contamination present or

possible (HazMat)? If so, figure type, extent, and

problems it may create like where contaminants

are going.

Handout

Points / persons of interest

If possible, identify job foreman or someone else

involved in incident prior to emergency and DO

NOT let this person go. They are a valuable

source of information. Identify MSDS, existing

ventilation systems, points of entry, and if there is

an entry permit. Fire department can use their

entry permit if available. If not, department can

produce their own. In any case, one must be

present before entry is made.

Shut down / lock out

When performing shut down, be careful that it

won’t shut down or disable essential systems such

as ventilation equipment.

Ventilation

Begin ventilation procedures if possible, the

earlier the better. Do not ventilate with pure O2.

II – Presentation, continued 20 Minutes

6. Legal requirements

These are in accordance with NFPA 1001 and

WAC 296

III – Application 20 Minutes

1. Review / recap

Restate in summary the course objectives to

confirm student understanding.

Discuss

2. Suggested Discussion Questions

Lead d a guided discussion based on the following

photographs:

1. Type = vault, manhole, tank; Hazards = IDLH

atmosphere, fall, engulfment, mechanical; Actions

= identify, set up command, isolate.

2. Type = trench; Hazards = IDLH atmosphere,

fall, collapse; Actions = identify, set up command,

isolate.

3. Type = well, manhole; Hazards = IDLH

atmosphere, fall, engulfment; Actions = identify,

set up command, isolate.

III – Application, continued

Lead a guided discussion based on safety systems

in the following photographs:

1. Ventilation, equipment, training levels.

2. Shoring, equipment, training levels.

4. Conclusion

If you leave this class with anything, the most

important thing to remember is, First responders

must not enter confined spaces!!! Even if there are

victims that may be rescued.

III. Evaluation 20 minutes

1. Performance Evaluation

Have each student complete quiz.

APPENDIX XV: Use of Safety Gear inside A Fire Scene (Sample)

Instructor pre-planning:

LESSON OBJECTIVE: By the end of this lesson, the student will be able to discuss at

least four concepts involving safety inside a burning building, using case studies and role-

play.

TASK ANALYSIS: Concepts to be introduced include CAL-OSHA mandates, exiting

the fire scene when the Vibra-Alert sounds, activation of PASS alarm prior to entering

the building, and proper fastening of safety gear.

The Lesson Plan

Warm up/ Review: Distribute roles for students to act out during the discussion. Once

students are ready to play their "part", introduce the safety lesson by preparing the

participants for watching a video described below.

Presentation or Demonstration: Play the video that presents the case studies of the two

firefighters who were seriously injured during a fire.

Student Practice: After the video is completed, lead a whole group discussion about

safety issues that were encountered by the firefighters. Allow pros and cons to develop,

but ensure that ultimately the message of mandatory safety practices is brought out.

Evaluation/Closure: To conclude this session, ask each participant of the discussion to

answer a summary question based upon the task analysis. Questions to be presented

include:

1. Who mandates our use of safety equipment during the fire scene?

2. When should one begin exiting the fire scene, in order to avoid potential problems

with the SCBA equipment?

3. Why should the PASS alarm be activated prior to entering the fire scene?

4. How should the outer firefighter safety clothing be worn during the fire scene?

APPENDIX XIX: Glossary of Terms

Accreditation To give official authorization to or approval of; to recognize

(an educational institution) as maintaining standards that

qualify the graduates for admission to higher or more

specialized institutions or for professional practice.

Affective domain Part of Bloom’s taxonomy, the affective domain deals with

feelings, thoughts and values.

Analytic learner Learning preference dealing with how a learner prefers to

take in information. An analytic learner prefers to look at

details, steps and minute elements. The opposite of an

analytic learner is a global learner.

Attribution Regarding education, attribution is a thought process where

an individual assigns responsibility for something. Example;

a student performs poorly on a practical examination. When

reviewing the reasons for poor performance, what does this

student attribute to the cause? (lack of preparation time, poor

teaching by the instructor, misunderstanding of the

procedure, unprepared for testing on that day, etc.)

Attribution is important in remediation because it shows how

much responsibility a student accepts for their failures.

Auditory preference A learner preference describing how a learner prefers to

receive information. An auditory learner prefers the sense of

hearing over other senses.

Certification The issuing of a certificate by a private agency based upon

standards adopted by that agency that are based upon

competency.

Clinical instructor

A member of the EMS education team whose focus in

teaching is the clinical setting. This individual must possess

a high level of proficiency in the performance of skills in

addition to their development as an EMS educator. The

clinical instructor often works very closely with students in a

real patient care environment.

Clinical setting Generally an actual patient care environment where student

will interact with real or simulated patients to practice skills

or to demonstrate skills proficiency.

CoAEMSP Committee on Accreditation of Educational Programs for the

Emergency Medical Service Profession provides

accreditation services for paramedic programs. Its primary

goal is to foster partnerships with educational programs in

continuous quality improvements.

Cognitive domain Part of Bloom’s taxonomy, the cognitive domain deals with

thinking and knowledge.

Cohort Group Several students who are attending a course together.

Continuing education The continual process of life-long learning that involves

learning new content materials. It is different from refresher

education which is a review of previously learned content.

Curriculum A particular course of study, offered in a special field. For

EMS education it is has traditionally included detailed lesson

plans.

Depth and breadth Depth refers to how far into a level of learning one should go

in teaching it and breadth refers to the amount of material to

cover (width). The greater the depth and breadth the more

fully the material is covered.

Didactic instruction Designed or intended to teach. Didactic instruction generally

deals with cognitive material needed for learning to take

place in the cognitive, affective and psychomotor domain.

Didactic instruction can be presented through a variety of

methods, including lecture, small group work, problem-

based learning, etc.

Discipline Orderly or prescribed conduct or pattern of behavior.

Domains of learning A method of categorizing learning into like groupings.

Bloom used three domains: cognitive, affective and

psychomotor. Other educational researchers have used more.

DOT-NSC Curriculum Department of Transportation National Standard.

Educational Objective The outcome/goal of the teaching/training conducted; the

desired knowledge to be imparted.

Entry level Refers to the novice or new EMS educator who has

completed a formalized course of study of the body of

knowledge proscribed by the EMS instructor curricula. This

individual may possess teaching experience or credentials

from another allied health field or education setting, but has

limited experience teaching EMS content.

Emergency Medical

Services

Collective name for all levels of certification or licensure for

individuals who provide out-of-hospital patient care.

EMS Agenda

for the Future

Public document finalized in 1996 that focuses on aspects of

EMS related to emergency care outside traditional health

care facilities. Serves as guidance for EMS providers, health

care organizations/institutions, governmental agencies and

policy makers committed to improving the health of their

communities and to ensure that EMS efficiently contributes

to that goal.

Emergency Medical

Technician

A member of the EMS team who provides out-of-hospital

emergency care; includes certification of EMT-Basic, EMT-

Intermediate, and EMT-Paramedic which identify

progressively advancing levels of care.

Formative evaluation Process of evaluation that is conducted while training is in

progress. It may be formal or informal but is generally

designed to provide the instructor and student with a

snapshot of where they are currently compared to where they

want to be.

Goals The end toward which effort is directed, goals in education

are the primary reason a course or program is being taught.

Global learner Learning preference dealing with how a learner prefers to

take in information. A global learner prefers to look at the

big picture first and then break it up into chunks to study.

The opposite of a global learner is an analytic learner.

Kinesthetic preference A learner preference describing how a learner prefers to

receive information. A kinesthetic learner prefers the sense

of touch over the other senses to learn.

Laboratory instructor Member of the EMS education team whose primary

responsibility is to assist students in learning psychomotor

skills. This individual must possess a high level of

proficiency in the performance of skills in addition to their

development as an EMS educator. The laboratory instructor

often works very closely with students in simulated patient

care environment, but they may work with actual patients.

Laboratory setting Generally a simulated patient care environment designed to

allow students to practice skills and techniques on simulated

patients.

Learning preference Another term for learning style. A learning preference is the

preferred mode or method a learner has for learning.

Learning style A preferred mode or method a learner has that is unique to

the way the perceive, store and retrieve knowledge and

information.

Lesson plan An instructional tool that allows the educator to map out

their plan for learning for a given time frame.

Mastery level EMS instructor who has demonstrated proficiency in all

areas of the art and science of education. This individual

often serves as a mentor to other instructors while continuing

to grow and develop their own skills.

Memory degradation Loss of memory that occurs over time.

Metacognition The process of thinking about thinking. Taking deliberate

steps to look at the processes one goes through to problem

solve.

Motivation

(intrinsic and extrinsic)

Intrinsic motivation comes from within an individual and is

the force driving someone to learn. Extrinsic motivation is

the driving force that is provided from outside of the

individual that serves to build within them a desire to learn.

Objective Expressing or dealing with facts or conditions as perceived

without distortion by personal feelings, prejudices, or

interpretations.

Pedagogy The art, science, or profession of teaching.

Performance

agreement

The process where goals, objective and content from a lesson

plan are compared to determine if they are working towards

achieving the same ends.

Portfolio A method of compiling educational products (lesson plans,

tests, slide presentations, games, etc.) generated by an

instructor that allows the instructor to present a

representative body of work for review and comment.

Primary instructor This member of the educational team is the individual who is

the main educator in charge of a cohort group of students

who are attending a course. In addition to providing and

coordinating classroom instruction, the primary instructor

also coordinates other aspects of the course or works closely

with a program director in the coordination of a course.

Professional educator An individual who is committed to lifelong learning and who

strives to increase their depth and breadth of knowledge and

skills of education.

Program director This member of the educational team is the individual who

has administrative oversight over one or several EMS

courses.

Psychomotor domain Part of Bloom’s taxonomy, the psychomotor domain deals

with skills, manipulations of objects, and muscular control.

Rubric An explanatory or introductory commentary, rubrics are also

learning tools that provide descriptions and help clarify

subjective information. For example, an objective may state

that a student must demonstrate proficiency in starting an IV.

A rubric will break down the grading scheme so students can

see exactly what criteria are required to demonstrate

proficiency.

Skills instructor Similar to a laboratory instructor, the skills instructor is a

member of the EMS education team whose primary

responsibility is to assist students in learning psychomotor

skills. This individual must possess a high level of

proficiency in the performance of skills in addition to their

development as an EMS educator. The skills instructor often

work with students in simulated patient care environment or

with actual patients.

Student handbook Instructional tool that describes the rules and regulations

pertinent to the specific program or course the student is

enrolled in.

Summative evaluation Process of evaluation that is conducted at the completion of

training. It is generally formal, but may be informal, and is

designed to test if students achieved the goals and objectives

identified for the course.

Taxonomy The study of the general principles of scientific

classification.

Visual preference A learner preference describing how a learner prefers to

receive information. A visual learner prefers the sense of

sight over other senses.